Introduction: Ever since the world came into being different factors and circumstances contributed in a deteriorating fashion to mental health, and depression is the commonest of mental disturbance and incapability. We aimed to identify the risk factors for perinatal outcomes of maternal depression. Methods: Data extracted was from two important cities of Pakistan i.e Islamabad and Karachi, and the numbers are 500,000 and 800,000 respectively. The timeline of the information was from 2010 to 2020 to signify a decade. Women with active pregnancy and depression were included. Chisquare analysis was run to predict which factors had a significant impact on depression. Odds ratio was separately run on the significant factors. Regression analysis was done to describe the relationships between independent variables and each other. Results: The most preferred procedure of delivery was cesarean section in Islamabad and more than 500,000 in Karachi. Low-income women in Karachi had a mean depression score of 12.4 while men with the same socioeconomic class had a score of 23.4. 15.7 females in Islamabad reported medications taken during pregnancy & 34.9 females from major depression group. Mean of 87.9 individuals from Islamabad reported living with husband from no serious depression during pregnancy. In Population of Islamabad, Previous pregnancies and birth weight in comparison with depression is significant having p value 0.00. Maternal age, fetal sex & gestational age are also significant indicators of whether a woman is depressed or not. Apgar scores & violence in relation to depression are significant in Karachi Population having p values of 0.049 and 0.028. Conclusion: Female health and neonatal care should be a serious concern, but unfortunately in spite of progression in the field of medicine the low income or third world countries don't have sufficient awareness and due to that Pakistan still reports high maternal and neonatal mortality rates.
Background: Frozen shoulder or adhesion capsulitis is a frequent ailment that causes pain and progressively restricts both active and passive shoulder motions. It is estimated that it affects 2%-5% of the general population and up to 20% of diabetes mellitus patients.We aimed to compare the effectiveness of three-site steroid injections against one-site injections in the treatment of adhesive capsulitis. Methodology: The Rheumatology Department of Pakistan Institute of Medical Sciences in Islamabad conducted this cross-sectional study. Between August 2021 to December 2021. The study comprised a total of 98 patients. This study included patients of both genders with shoulder pain between the ages of 40 and 70.Patients were divided into two groups & dosage was given at Sub-coracoid, Subacromial, and Posterior Capsule.The CONSTANT score was used to assess patients three times (Initial, 3months & 6 months later). Results: The average age, gender distribution, and dominant/non-dominant side ratio of the participants were nearly identical between the two groups. More patients in group B (77.22 8.17) had a higher mean CONSTANT score than those in group A (72.73 7.05). Patients were checked in on again after three and six months. Conclusion: The three-site injection technique is a safe and effective method for frozen shoulder. It provides an early recovery and improved shoulder function with a reduced frequency of relapse as compared to single-site injection techniques.
Background and objective Severe Clostridium difficile (C. difficile) infection (CDI)-related colitis is associated with high morbidity and mortality. Current guidelines recommend oral vancomycin plus intravenous metronidazole as the first-line treatment and early total colectomy in case of medication failure. In critically ill patients at high surgical risk and with multiple comorbidities, loop ileostomy creation and enteral vancomycin infusion have been employed albeit with limited success. We hypothesized that continuous enteral vancomycin (CEV) infusion via a postpyloric feeding tube would provide a less invasive, efficacious, and safer route to treat high surgical risk patients. Methods All adult (>18 years) non-pregnant patients admitted to the ICU for severe CDI from October 2012 to October 2016 and received CEV after the failure of conventional therapy were included. Vancomycin was prepared as a 1-2-mg/ml enteral solution and run continuously through a feeding pump at 42 ml/hour via a post-pyloric feeding tube. The primary efficacy endpoint was clinical improvement defined as (a) decrease in stool output, (b) decreased vasopressor requirement, or (c) improved leukocytosis, and the secondary endpoint was treatment failure defined as the need for total colectomy or death due to severe CDI. Results Our cohort comprised 11 patients in total. The median age of the participants was 64 years, and there were more females (67%) than males (36%). Clinical improvement was seen in seven patients (63%); treatment failure documented as the need for total colectomy was observed in two patients (18%), and death attributable to CDI occurred in three patients (27%). Conclusion CEV resulted in clinical improvement in most patients with severe CDI who were at high surgical risk. Sustained intestinal vancomycin delivery may increase luminal concentration and bactericidal effect. The use of a feeding tube and pump provides an effective and less invasive route of vancomycin delivery in critically ill patients.
